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目的 探讨"推拉牵引-放松归位-反复确认"技术在腹腔镜胆囊切除术(1aparoscopic cholecystectomy,LC)中预防胆道损伤的临床价值.方法 2001年3月至2009年8月,笔者应用此项技术完成LC 4800例.每例患者均采用"推拉牵引"显露三角区的结构,"放松归位"恢复胆囊管、肝总管和胆总管的生理位置,"反复确认"多次明确胆囊管、肝总管和胆总管的关系后再离断胆囊管.结果 全组患者无胆道损伤发生;118例分别因胆囊Calot三角结构识别困难、胆管结石、胆囊癌和胆囊一十二指肠内瘘转开腹手术.结论 "推拉牵引-放松归位-反复确认"技术能有效的预防LC术中胆管损伤,方法简单,容易掌握,值得推广.Abstract： Objective To study the value of the technique of "Push-pull traction-relax homingrepeatedly confirmed" in the prevention of bile duct injury in LC. Methods From March 2001-August 2009, we applied this technique in 4800 cases of LC. The technique of "Push-pull traction" showed the structures of in the Calot's triangle. The technique of "relax homing" was to restore the cystic duct,hepatic duct and common bile duct to their original anatomical positions. The technique of "repeatedly confirmed" repeatedly identified the positions of the cystic duct, the common hepatic duct and the common bile duct. Results There was no bile duct injury. Conversion to open surgery happened in 118patients due to difficulties in identifying the Calot's triangle structures, bile duct stones, gallbladder cancer, and gallbladder-duodenal fistula. Conclusions The "Push-pull traction-relax homing-repeatedly confirmed" technique could effectively prevent bile duct injury in LC. The method is simple, easy to master and worthy of promotion. 相似文献
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目的探讨一２３－Ｈ;基因在人乳腺癌和良性乳腺疾患中的表达规律．及其与淋巴结转移等预后因素之间的关系．方法乳腺组织标本共７６例,ＨＥ染色对病变进行病理诊断,以且抗人ｕｒｎ刀一写单克隆抗体ＩｇＧ。、用免疫组化方法检测ｎ。２３－Ｈ;基因在乳腺组织中的表达产物．结果①＂ｍ２３－Ｈ;表达产物位于胞浆;②＂ｍ２３一马表达频率在良性乳腺疾患中明显高于乳腺癌中;③＂ｍ２３一ｑ的表达与乳疗淋巴结转移负相关．结论＂ｍ２３－Ｈ;的检测在评估乳腺肿瘤的恶性程度及淋巴转移上有肯定的意义,且是评估乳腺癌患者预后有价值的生物学指标． 相似文献